Prediction of lateral pelvic lymph node metastasis from lower rectal cancer using magnetic resonance imaging and risk factors for metastasis: Multicenter study of the Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum

Ogawa, Shimpei; Hida, Jin‐ichi; Ike, Hideyuki; Kinugasa, Tetsushi; Ota, Mitsuyoshi; Shinto, Eiji; Itabashi, Michio; Okamoto, Takahiro; Yamamoto, Masakazu; Sugihara, Kenichi; Watanabe, Toshiaki

doi:10.1007/s00384-017-2874-9

Cited by 24 publications

(24 citation statements)

References 32 publications

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“…The cut-off value of size-based diagnosis for rectal cancer is inconsistent; for example, Akiyoshi et al (5) reported that 8 mm is the optimum cut-off for prediction of LPLN metastasis on MRI, whereas Ogawa et al (6) proposed a cut-off of 5 mm. Therefore, the accuracy of size-based diagnosis is uncertain and other methods to predict metastasis have been examined.…”

Section: Discussionmentioning

confidence: 99%

“…Appropriate introduction of preoperative treatment requires accurate prediction of lymph node metastasis prior to surgery. At present, size-based diagnosis using the maximum short axis diameter of LNs on computed tomography (CT) or magnetic resonance imaging (MRI) is predominantly used to predict metastasis (5,6). However, diagnostic accuracy of size-based diagnosis is unsatisfactory.…”

Section: Introductionmentioning

confidence: 99%

“…However, diagnostic accuracy of size-based diagnosis is unsatisfactory. Ogawa et al (6) reported diagnostic accuracy of short axis diameter for pararectal LN (PRLN) was 63.7% (cutoff; 5 mm) and for laterally pelvic lymph node (LPLN) was 77.6% (cutoff; 5 mm) in MRI findings. These accuracies were not enough to introduce preoperative therapy appropriately, so studies focusing on the 'quality' of LNs have recently been tried to improve the diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

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Dual energy CT is useful for the prediction of mesenteric and lateral pelvic lymph node metastasis in rectal cancer

et al. 2019

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The aim of the present retrospective study was to investigate the predictability of dual-energy computed tomography (DECT) for pararectal lymph node (PRLN) metastasis and lateral pelvic lymph node (LPLN) metastasis in rectal cancer (RC). The present study involved 44 patients with RC who were examined by DECT and then underwent surgery between May 2015 and September 2017. LPLN dissection was performed in 24 patients. The normalized iodine concentration (nIC), the ratio of iodine concentration in the lymph node (LN) to that in the common iliac artery on DECT, of the largest PRLN and LPLN was calculated, and the association between LN metastasis and nIC was analyzed. The median nIC value for PRLNs was significantly lower in PRLN metastasis-positive cases compared with PRLN metastasis-negative cases in the arterial phase [0.18 vs. 0.25; P=0.01; cutoff , 0.24; area under the curve (AUC), 0.733] and portal phase (0.47 vs. 0.61; P= 0.03; cutoff , 0.59; AUC, 0.701). A significant difference was not identified between the median maximum short axis diameter of PRLNs in PRLN metastasis-positive and metastasis-negative cases (7.6 vs. 6.4 mm; P=0.33). The nIC for LPLNs was not significantly different between LPLN metastasis-positive and metastasis-negative cases in the arterial phase (0.15 vs. 0.21; P= 0.19); but was significantly lower in LPLN metastasis-positive cases compared with LPLN metastasis-negative cases in the portal phase (0.29 vs. 0.56; P=0.04; cutoff , 0.29; AUC, 0.877). The maximum short axis diameter of LPLNs was significantly larger in metastasis-positive cases compared with LPLN metastasis-negative cases (9.1 vs. 4.8 mm; P=0.03; cutoff , 7.0 mm; AUC, 0.912). In conclusion, the nIC was identified to be significantly lower in metastasis-positive cases, which may be useful for the prediction of PRLN and LPLN metastases. A combination of size-based diagnosis and DECT may increase the accuracy of preoperative diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dual energy CT is useful for the prediction of mesenteric and lateral pelvic lymph node metastasis in rectal cancer

et al. 2019

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“…For nodes in the lateral pelvis, mostly size criteria have been tested, with variable cutoffs and variable outcomes [52][53][54][55][56]. According to research by the Lateral Node Study Consortium, in the particular case of cT3/4 low tumours, lateral lymph nodes with a short axis of at least 7 mm on staging MR have a significantly higher risk of lateral recurrence and lateral lymph node dissection in such cases may reduce lateral recurrences significantly [57].…”

Section: Lymph Node Involvement and Tumour Depositsmentioning

confidence: 99%

MRI of rectal cancer—relevant anatomy and staging key points

et al. 2020

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Rectal cancer has the eighth highest cancer incidence worldwide, and it is increasing in young individuals. However, in countries with a high human development index, mortality is decreasing, which may reflect better patient management, imaging being key. We rely on imaging to establish the great majority of clinical tumour features for therapeutic decision-making, namely tumour location, depth of invasion, lymph node involvement, circumferential resection margin status and extramural venous invasion. Despite major improvements in technique resulting in better image quality, and notwithstanding the dissemination of guidelines and examples of standardised reports, rectal cancer staging is still challenging on the day-today practice, and we believe there are three reasons. First, the normal posterior pelvic compartment anatomy and variants are not common knowledge to radiologists; second, not all rectal cancers fit in review paper models, namely the very early, the very low and the mucinous; and third, the key clinical tumour features may be tricky to analyse. In this review, we discuss the normal anatomy of the rectum and posterior compartment of the pelvis, systematise all rectal cancer staging key points and elaborate on the particularities of early, low and mucinous tumours. We also include our suggested reporting templates and a discussion of its comparison to the reporting templates provided by ESGAR and SAR.

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“…The metastatic lymph nodes showed uneven texture and invisible lymphatic hilum structure under ultrasound. PET -CT for rectal cancer currently also has reference value for the existence of lymph node metastasis, tumor metastasis of lymph nodes will appear in the accumulation of radioactive solid glucose, similar with the DWI (diffusion weighted imaging) can iliac blood vessels weeks about the existence of rectal cancer lymph node metastasis is helpful, but recently some scholars metastatic lymph nodes of PET judgment, sensitivity analysis, only 62% [28][29][30][31][32][33][34][35]. Recently, by combining artificial intelligence with tumor imaging and comparing big data of lymph node metastasis with tumor imaging of patients, the probability of judging lymph node metastasis is estimated to be 77.8% [31,13,[36][37][38][39][40][41][42][43].…”

Section: How To Accurately Evaluate Lymph Nodes By Rectal Magnetic Resonancementioning

confidence: 99%

Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer

Ni¹,

Huang²,

Liao³

et al. 2020

IJCOCR

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AIM: Objective to evaluate the clinical value of therapeutic lateral lymph node dissection in advanced rectal cancer after neoadjuvant radio-chemotherapy in patients with peritoneal retroperitoneum under MR suggesting perivascular iliac lymph node enlargement (lymph node diameter > 8mm). Methods: Because of this study is a retrospective study, the propensity to evaluate matching group is adopted to one group to Fujian Medical University Union Hospital, Fujian province hospital from January 2009 to June 2014 treated 103 cases of rectum MR images after neoadjuvant chemoradiation weeks iliac blood vessels have the progress of the lymph node enlargement period under peritoneal fold return rectal cancer line TME + therapeutic cases of lateral lymph node cleaning; In the group 2, 192 cases with the same tumor site, stage, type, gender and age as group 1 or similar were matched for the same period by propensity assessment, while the group 2 received TME only. The incidence of pelvic autonomic nerve injury after surgery, the 3-year local recurrence rate of pelvic cavity, and the 5-year tumor-free survival rate were compared between the two groups, so as to explore the clinical value of therapeutic periiliac dissection for advanced rectal cancer under peritoneal reflux. Results: The local recurrence rate of pelvic cavity in group 1 and group 2 was 2.91% (3/103) and 9.90% (19/192), respectively, 3 years after operation (P<0.05). Postoperative dysuria in group 1 and group 2 was 14.56% (15/103) and 5.21% (10/192), respectively, with significant difference (P<0.05). Postoperative sexual dysfunction in group 1 and group 2 was 12.50% (7/56) and 2.15% (2/93), respectively, with significant difference (P<0.05). The 5-year survival rates of group 1 and group 2 were 54.37% (56/103) and 51.56% (99/192), respectively, with no significant difference (P›0.05). The liver metastasis rates of group 1 and group 2 were 26.21% (27/103) and 29.17% (56/192), respectively. Lung metastasis rates in group 1 and group 2 were 19.41% (20/103) and 19.27% (37/192), respectively. Conclusion: After neoadjuvant chemoradiotherapy for advanced rectal cancer, selective lymphatic dissection along the iliac vessels guided by rectal magnetic resonance can reduce the local pelvic recurrence of patients for 3 years, but increase the probability of pelvic autonomic nerve injury, and periiliac lymph node dissection will not increase the 5-year survival rate of patients.

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Prediction of lateral pelvic lymph node metastasis from lower rectal cancer using magnetic resonance imaging and risk factors for metastasis: Multicenter study of the Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum

Abstract: A logistic model including risk factors for LPLN metastasis and MRI findings had significantly better performance for prediction of LPLN metastasis compared with a model based on MRI findings alone.

Cited by 24 publications

References 32 publications

Dual energy CT is useful for the prediction of mesenteric and lateral pelvic lymph node metastasis in rectal cancer

Dual energy CT is useful for the prediction of mesenteric and lateral pelvic lymph node metastasis in rectal cancer

MRI of rectal cancer—relevant anatomy and staging key points

Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer

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